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Table of Contents
About The Book
A reassuring and illuminating examination on our conflicting wishes about the end of life, how the politics and routines of the American hospital have formed our understanding and experience of death, and ultimately why what we consider a "good death" is so hard to attain.
In a penetrating and revelatory study, medical anthropologist Dr. Sharon Kaufman uses two years of intensive observations and interviews with scores of patients, family members, physicians, nurses, social workers, and other staff at several community hospitals in California to explore the heart of a science-driven yet fractured and often irrational world of health care delivery, where empathetic yet frustrated, hard-working yet constrained professionals both respond to and create the anxieties and often inchoate expectations of patients and families, who must make "decisions" they are ill-prepared to make.
She sought out the critically ill, the dying and their friends and relatives. She followed patients from admission to death—days, weeks, or sometimes months later—through, what is often for them and their families, a Kafka-esque journey. She asked hospital staff what they were doing and why and stood beside doctors and nurses, observing their work, cynicism, compassion and frustration. And she paid close attention to the most important player of allthe hospital beauracracy and how it impacts the manner and timing of patient death.
Her investigative research links together the emotional experiences of patients and families, the dedicated work of hospital staff and the ramifications of institutional bureaucracy to show the invisible power of the hospital system itself—its rules, mandates and daily activity—in organizing death and individual experience of it. The book is the story of real patients and their families, an account of what drives the American hospital today, and a report on the complex sources and implications of doing something about death.
In a penetrating and revelatory study, medical anthropologist Dr. Sharon Kaufman uses two years of intensive observations and interviews with scores of patients, family members, physicians, nurses, social workers, and other staff at several community hospitals in California to explore the heart of a science-driven yet fractured and often irrational world of health care delivery, where empathetic yet frustrated, hard-working yet constrained professionals both respond to and create the anxieties and often inchoate expectations of patients and families, who must make "decisions" they are ill-prepared to make.
She sought out the critically ill, the dying and their friends and relatives. She followed patients from admission to death—days, weeks, or sometimes months later—through, what is often for them and their families, a Kafka-esque journey. She asked hospital staff what they were doing and why and stood beside doctors and nurses, observing their work, cynicism, compassion and frustration. And she paid close attention to the most important player of allthe hospital beauracracy and how it impacts the manner and timing of patient death.
Her investigative research links together the emotional experiences of patients and families, the dedicated work of hospital staff and the ramifications of institutional bureaucracy to show the invisible power of the hospital system itself—its rules, mandates and daily activity—in organizing death and individual experience of it. The book is the story of real patients and their families, an account of what drives the American hospital today, and a report on the complex sources and implications of doing something about death.
About The Author
Photo Credit:
Sharon R. Kaufman is professor of medical anthropology at the University of California, San Francisco. She is the author of numerous articles, book chapters, and several books including, And a Time to Die, The Healer's Tale, and The Ageless Self. She lives with her husband in the San Francisco Bay Area.
Product Details
- Publisher: Scribner (April 19, 2005)
- Length: 416 pages
- ISBN13: 9780743282529
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Raves and Reviews
Thomas Lynch author of The Undertaking, Life Studies from the Dismal Trade and Bodies in Motion and at Rest: On Metaphor and Mortality. Kaufman works those difficult borders between medicine and humanity, between "holding on" and "letting go," between sickness and ceasing to be -- drawing the reader nigh (to paraphrase Wallace Stevens) not only the idea of the thing, but the thing itself. Here is a compelling witness to how we manage mortality and what it means. A neccessary text for professional and common readers.
Muriel Gillick, MD Associate Professor Harvard Medical School, author of Lifelines: Living Longer, Growing Frail, Taking Heart Kaufman brilliantly captures the ethos of the American intensive care unit. I can no longer walk into the ICU of the teaching hospital where I practice without hearing the relentless drumbeat that Kaufman describes, the rhythm marking that special sense of time evident only to the physicians and nurses in the ICU. It is a clock that tells practitioners when to "do everything" and when to withdraw treatment, a clock whose ticking is often inaudible to patients and families, with sometimes tragic consequences. This is a book that anyone who wants to understand the contemporary American hospital should read.
Howard Spiro M.D. Emeritus Professor of Medicine Yale University School of Medicine and author of The Power of Hope: A Doctor's Perspective
Reading this book is like listening in on the conversations and problems that American physicians have in caring for the dying and their families, the tragic choices for which nobody-not even living wills-- can really plan. Sharon Kaufmann vividly describes the harrowing scenarios, impossible for anyone to control, awaiting those of us who must die in hospitals, or more realistically begin the "process of dying," so transformed and so stretched by modern technology.
There are good routines for medical care and for cure, but patients and their families, physicians and other "healthcare workers", have such different concepts of life and consciousness, of dignity and duty, of faith and obligation , that there can never be agreement on how we die or how we should die.
Robert N. Butler, M.D., President and CEO International Longevity Center USA This fine work, Sharon Kaufman's new book, should help policy makers and physicians transform the experience and culture of death in America.
Resources and Downloads
High Resolution Images
- Book Cover Image (jpg): And a Time to Die eBook 9780743282529(1.7 MB)
- Author Photo (jpg): Sharon Kaufman Photo Credit:(0.1 MB)
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